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Submitted by Hítalla Fernandes dos Santos (hitallapsy@gmail.com) on 2018-12-10T12:45:31Z No. of bitstreams: 4 Dissertacao_Hitalla_2018.pdf: 1819023 bytes, checksum: e98921c5fa9e8b8db5f5c2992db87c1e (MD5) Carta de Encaminhamento.pdf: 196318 bytes, checksum: f84ea0b4fbc528ffeaf7cf7505a8c5df (MD5) Ata.pdf: 305252 bytes, checksum: fcc0a0ab742f549dff815fc1d66ffa3b (MD5) Parecer Final (1).pdf: 130990 bytes, checksum: 9ad65176bf77fec9a90129e5940d085b (MD5) / Approved for entry into archive by PPGPSI Psicologia (ppgpsiufam@ufam.edu.br) on 2018-12-11T00:33:49Z (GMT) No. of bitstreams: 4 Dissertacao_Hitalla_2018.pdf: 1819023 bytes, checksum: e98921c5fa9e8b8db5f5c2992db87c1e (MD5) Carta de Encaminhamento.pdf: 196318 bytes, checksum: f84ea0b4fbc528ffeaf7cf7505a8c5df (MD5) Ata.pdf: 305252 bytes, checksum: fcc0a0ab742f549dff815fc1d66ffa3b (MD5) Parecer Final (1).pdf: 130990 bytes, checksum: 9ad65176bf77fec9a90129e5940d085b (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2018-12-11T14:06:43Z (GMT) No. of bitstreams: 4 Dissertacao_Hitalla_2018.pdf: 1819023 bytes, checksum: e98921c5fa9e8b8db5f5c2992db87c1e (MD5) Carta de Encaminhamento.pdf: 196318 bytes, checksum: f84ea0b4fbc528ffeaf7cf7505a8c5df (MD5) Ata.pdf: 305252 bytes, checksum: fcc0a0ab742f549dff815fc1d66ffa3b (MD5) Parecer Final (1).pdf: 130990 bytes, checksum: 9ad65176bf77fec9a90129e5940d085b (MD5) / Made available in DSpace on 2018-12-11T14:06:43Z (GMT). No. of bitstreams: 4 Dissertacao_Hitalla_2018.pdf: 1819023 bytes, checksum: e98921c5fa9e8b8db5f5c2992db87c1e (MD5) Carta de Encaminhamento.pdf: 196318 bytes, checksum: f84ea0b4fbc528ffeaf7cf7505a8c5df (MD5) Ata.pdf: 305252 bytes, checksum: fcc0a0ab742f549dff815fc1d66ffa3b (MD5) Parecer Final (1).pdf: 130990 bytes, checksum: 9ad65176bf77fec9a90129e5940d085b (MD5) Previous issue date: 2018-10-25 / FAPEAM - Fundação de Amparo à Pesquisa do Estado do Amazonas / This dissertation analyzes the psychiatric demand that is present at the Psychosocial Attention Center – CAPSi (in Portuguese) – in east side of Manaus, so it is based on public policies on children and teenaged’s mental health. It was studied and researched the mental disorders prevalent in children between 6 to 10 years old, the reasons and the complaints that are presented by the child's parents or their responsible at the time of the hosted, and the dynamics established in the team in treatment or in some new referrals. The theoretical references used address complementary themes and they interact with themselves about mental health and childhood from the perception and concepts of Critical Social Psychology. First, it is described the historical trajectory of childhood in the World, in Brazil and also in the State of Amazonas, indicating the existence of children's plurality, as well as the urgent need to recognize unique features of each child. In a second time, it is important to relate the historical evolution of the mental health field in Brazil and in the State of Amazonas; it reflects a significant delay in the implementation of public policy established by the Health Ministry. The theoretical referential is closed when the pathologization and the children medicalization are addressed as a device of biopower, that make the child in docile body with medicine in the search to that it responds exactly what they want. As a methodological resource this study goes deeper in the field-theme from the entrance into East CAPSi, using the documentary analysis of medical records and the participant observation, and open interview with the Direction of the place, from where fictional narratives were extracted and interlinked with the narratives that were collected in the experience of years with young children and their parents in the school level as a means of. It was analyzed 146 medical records, 115 were from boys and 31 were from girls; a statistical survey was made on all the medical records of these children hosted by the East CAPSi in the period from July 2016 to June 2017, the data were entered into the Statistical Package for Social Sciences – SPSS. It is believe that the figures presented go beyond the quantitative. Intrinsically, they indicate information associated to the service offered by East CAPSi. Through the fictional narratives constructed and qualitative analysis of the data, it is concluded that in the face of a different social historical reality hygienist period, occurred until the middle of the 19th century, where the real conception of childhood is not the same, it is possible to find similar actions that lead the practice of professionals in the mental health service. This reality finds support in the dynamics of work established by East CAPSi. The research has shown that the vast majority of the mental disorders received are related to the child's behavior. The most attended are conduct disorders and Attention Deficit Hyperactivity Disorder - AD/HD or TDAH (in Portuguese). It also showed the young children expressiveness medicated with Risperidon, presented as the magic formula that is capable of changing the child's restless behavior. The research also revealed how distant the State of Amazonas is from that is recommended in GM Ordinance No. 336, it has a CAPSi for a city with more than 2 million people. Directly, it implies in the daily professionals practices and results in a large number of new referrals to services that could be attend internally, it was not the waiting list. / A presente dissertação tem como objetivo analisar a demanda psiquiátrica acolhida no Centro de Atenção Psicossocial – CAPSi Leste de Manaus, logo, embasamo-nos nas políticas públicas em saúde mental infantojuvenil. Investigamos quais os transtornos mentais prevalentes em crianças de 6-10 anos, quais motivos/queixas são apresentados pelos responsáveis da criança no momento do acolhimento, bem como a dinâmica estabelecida entre a equipe no tratamento ou em eventuais novos encaminhamentos. O referencial teórico utilizado aborda temas complementares e que dialogam entre si sobre a saúde mental e infância a partir da percepção e conceitos da Psicologia Social Crítica. Para tanto, inicialmente traça-se a trajetória histórica da infância no Mundo, no Brasil e também no Amazonas, apontando para a existência da pluralidade infantil, bem como a urgência em reconhecer as singularidades que constituem cada criança. Em um segundo momento, faz-se importante traçar o percurso histórico trilhado no campo da saúde mental no Brasil e no Amazonas; o qual reflete um atraso significativo na implantação da política pública instituída pelo Ministério da Saúde. Fecha-se o referencial teórico ao abordar a patologização e medicalização infantil como dispositivo do biopoder, que torna a criança em corpo dócil com medicamento na busca que ela responda exatamente o que desejam. Como recurso metodológico aprofundamo-nos no campo-tema a partir da entrada no CAPSi Leste, utilizando a análise documental dos prontuários, observação participante e entrevista aberta com a Direção, onde foram extraídas narrativas ficcionais que se entrelaçaram com as narrativas colhidas na vivência de anos com crianças pequenas e seus pais no âmbito escolar, como instrumentos. Analisamos 146 prontuários, sendo 115 de meninos e de 31 meninas; foi realizado um levantamento estatístico acerca de todos os prontuários destas crianças/usuárias acolhidas pelo CAPSi Leste no período de julho de 2016 a junho de 2017, os dados foram dispostos no SPSS – Statistical Package for Social Sciences. Acreditamos que os números apresentados vão além do quantitativo: eles revelam informações intrinsecamente ligadas ao serviço ofertado pelo CAPSi. Mediante as narrativas ficcionais construídas e análise qualitativa dos dados, concluímos que mesmo diante de uma realidade histórica social diferente do período higienista ocorrido até a metade do século XIX, onde a própria concepção de infância não é a mesma; é possível encontrar ações semelhantes que continuam regendo a prática dos profissionais no serviço de saúde mental. Tal realidade encontra respaldo na dinâmica de trabalho estabelecida pelo CAPSi Leste, cuja investigação revelou que a grande maioria dos transtornos mentais acolhidos estão relacionados ao comportamento da criança, são os transtornos de conduta e TDAH os mais atendidos; bem como revelou a expressividade de crianças pequenas medicadas com Risperidona apresentada como a fórmula mágica capaz de modificar o comportamento agitado da criança. A investigação revelou ainda o quão distante estamos enquanto Estado do Amazonas do que é preconizada na Portaria GM nº 336, tendo um CAPSi para uma cidade de mais de 2 milhões de pessoas, implicando diretamente nas práticas diárias dos profissionais, resultando em um grande número de novos encaminhamentos para serviços que poderiam ser tratados internamente, não fosse a lista de espera.

Teacher-Child Interaction Therapy (TCIT), which is an adaptation of the empirically-based treatment of Parent-Child Interaction Therapy (PCIT), addresses the needs of children and teachers through increasing positive teacher-child interactions while educating teachers on effective discipline techniques. The theoretical and empirical basis for PCIT provides the foundation for the appropriate and effective application of the adaptation of this treatment model for use with teachers.<br>The efficacy of Teacher-Child Interaction Therapy (TCIT) with a clinical preschool population was evaluated through a single subject A-B design conducted across subjects. The current study examined the impact of the intervention, TCIT, on child behavior, teacher skill development and use, as well as the quality of teacher-child relationships. Results suggest that the intervention positively impacted the behavior of preschool children diagnosed with a Disruptive Behavior Disorder, as indicated by a reduction of disruptive behaviors and increase of prosocial behaviors within a therapeutic classroom setting. Additionally, teacher skill use and the quality of teacher-child relationships were evaluated following implementation of the TCIT intervention. Findings indicate that the intervention positively impacted teachers use of the positive attention skills over the course of the intervention.<br>This study, which examined the efficacy of Teacher-Child Interaction Therapy with preschool-aged children diagnosed with a Disruptive Behavior Disorder, provides initial support for the implementation of a relationship-based technique to support teachers in addressing the disruptive behaviors of children within a classroom environment. / School of Education; / School Psychology / PhD; / Dissertation;

The optimal relational experiences of infants and young children demand a cross-sector workforce informed by Infant and Early Childhood Mental Health (IECMH) principles and practices. A recent review by the Alliance for the Advancement of Infant Mental Health, Inc identified seven themes that help define “What makes an IECMH association strong?”: (1) Identity, (2) Cross-Systems Collaborations, (3) Sound Organizational Structure, (4) Competency-Informed Training, (5) Reflective Supervision Capacity, (6) Policy, and (7) Higher Education. The present paper documents the story of the Association of Infant Mental Health in Tennessee (AIMHiTN) and the role of the Endorsement for Culturally Sensitive, Relationship-Focused Practice Promoting IECMH in that growth across those seven themes with the additional themes of (8) Funding and, (9) Diversity, Equity, Inclusion, and Belonging. First, foundational literature is reviewed to summarize IECMH-informed workforce development. Next, AIMHiTN's story of workforce development is mapped onto the nine themes and challenges and lessons learned are summarized. The article aims to serve as a roadmap for other states, provinces, territories, or nations hoping to develop their own Association for Infant Mental Health (AIMH) as well as a guide for those with existing AIMHs for promoting continued growth and sustainability.

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that inhibited or enhanced five mothers' recognitions. These factors were then evaluated using a frequency distribution analysis and a rank-order correlation. The phenomenon of recognition was, for these mothers, a process of waiting to hear that 'normal' had stopped, wherein they miscategorized symptoms as normal behaviors in a passing developmental phase. Prior experience with mental illness appeared to significantly decrease both the length of time and the level of distress necessary for recognition. Ultimately, recognition did not occur until someone in their social network validated their concerns and provided explicit confirmation, which galvanized them to seek treatment. Governance network collaborations can facilitate positive social change by standardizing guidance on how to differentiate symptoms of a disorder from normal childhood development. Public policies and programs such as universal mental health screening, mental health literacy, and more supportive and responsive school policies can foster dialogue for parental recognition in Colorado and throughout the country.

Mental health reflects an array of causal influences that span biological, psychological, and social circumstances, with resultant underlying causal pathways to poor mental health outcomes in childhood that are complex. Key features of this complexity are reciprocal interactions between person and environment that take place over time. The core of this thesis seeks to attend to the complexity of development to move the field of developmental health forward toward greater explanation, and more successful prediction and prevention. The focal point of the thesis is the psychosocial determinants of childhood mental health, the resource domain of the developing child, and the interplay between characteristics of the individual child, the family, and the community. The eventual goal is to better understand why and how socioeconomic circumstances impact on developmental health. One component of this thesis focuses on the expansion of extant developmental theory. The other component focuses on the development of an analytic strategy that more appropriately reflects the intricacies of this theoretical expansion. In the process, data are analysed, principally as a heuristic strategy, to illustrate the analytical approach needed to support the theoretical framework. The specification of a bioecological conceptual framework suitable to guide research and policy in developmental health is the first principal objective of the thesis. A critical examination of the resource framework proposed by Brooks-Gunn, Brown, Duncan, and Anderson Moore (1995) reveals it to be centred on family and community resources, but otherwise silent with respect to the physical and psychological resources of the child. The quintessential point of this thesis is that theory in developmental health must be able to account for the contribution individuals make to their own development. A modified resource framework is proposed that acknowledges financial, physical, human, and social capital, within the domains of the individual child, the family, and the community. The second principal objective of the thesis, the development of analytical methods that focus on the individual child and the complexity of data generated by this theoretical approach, is then introduced. Theory and method are thus integrated when comprehensive measures of characteristics in multiple domains across developmental periods are modeled using longitudinal data from the Western Australian Pregnancy Cohort (Raine) Study (Newnham, Evans, Michael, Stanley, & Landau, 1993). The mothers of 2,860 children were enrolled at 18 weeks in pregnancy and the children have been followed at birth, one, two, three, five, and eight years of age. Eighty-nine per cent (2,537 /2,860) of families were available for follow-up at eight and 74 per cent (2,126/2,860) of families responded. Extensive demographic, psychological, and developmental data were available for the children and their families and a limited amount of data were available for the communities in which they reside. A measure of mental health morbidity, the Child Behaviour Checklist (Achenbach, 1991), was available for the children at two, five, and eight years of age. In the first instance, dichotomous summary variables are derived for the demographic, psychological, and developmental variables of interest. Variables are then selected for inclusion in one of several explanatory models. To create a mathematical representation of resource characteristics, the information for each child is concatenated as a series of binary strings. Frequency tabulation is then used to aggregate the data and odds ratios are calculated to determine the degree of risk associated with each string of code, or pattern of factors relative to a nominated mental health outcome. The results provided a scaffold from which this theoretical and analytical approach is compared and contrasted with the reviewed literature. Two principal themes of investigation are pursued. The first theme to be examined is the interplay between characteristics of the child, family, and community and the contribution children make to their own development. The specific approach models the interaction between selected characteristics of the child, family and community in each of four developmentally significant time periods. The theoretical position adopted in the present study suggests that the effect of any personal or contextual factor on later development, if a relationship does truly exist, is most likely to be differential. That is, it is a combination of influences that determines developmental outcomes for children, not any single factor acting independently. The modelling process demonstrates that, for the children involved, personal and contextual factors impact mental health differentially depending on various other individual, family and/or community characteristics. The modelling process identifies patterns of factors that impact relatively small, but significant, numbers of children because the models focus on the effect for individual children rather than the effect for the group. For example, one model suggests that the effect of intra-uterine growth restriction for the group as a whole may be minimal, but the impact for some children could be critical depending on the combination of family and community influences, such as the mothers level of education, the family’s experience of significant life stress, and residence in a relatively disadvantaged community. The second theme to be examined is the possibility that the accumulation of resource deficits or risk characteristics, over time, amplifies the likelihood of mental health problems in childhood. The approach models selected characteristics of the child in each of the four periods of development collectively, and it also models selected characteristics spanning each of the four time periods discretely. The results suggest that latency, pathway, and recency effects may operate simultaneously, and that timing and accumulated burden may both be important determinants of risk. For example, with regard to children whose family experienced life stress, these three effects operated in a systematic way to increase the degree of risk of a mental health problem. In summary, the aggregation of data at the individual level is a productive approach in seeking to explain population level social phenomena. While seemingly paradoxical, the identification of the joint, interactive effects between individual, family, and community characteristics, better allows for the quantification of family and community characteristics operating through multiple causal pathways.

Mental illness is not only the leading cause of disability among adults, but there is also an emerging public health crisis in childhood mental illness. A majority of parents do not recognize symptoms of psychological disorder in their children, and current policies and programs for mental health service delivery are not sufficiently responsive to the early help-seeking dynamics of families. Using a concurrent mixed methods design, this study explored how parents in the Pikes Peak region of Colorado learned to recognize their child's mental illness. Phenomenological interviews, augmented by poetic inquiry and quantitative measurements, were used to discover factors that inhibited or enhanced five mothers' recognitions. These factors were then evaluated using a frequency distribution analysis and a rank-order correlation. The phenomenon of recognition was, for these mothers, a process of waiting to hear that â??normalâ?? had stopped, wherein they miscategorized symptoms as normal behaviors in a passing developmental phase. Prior experience with mental illness appeared to significantly decrease both the length of time and the level of distress necessary for recognition. Ultimately, recognition did not occur until someone in their social network validated their concerns and provided explicit confirmation, which galvanized them to seek treatment. Governance network collaborations can facilitate positive social change by standardizing guidance on how to differentiate symptoms of a disorder from normal childhood development. Public policies and programs such as universal mental health screening, mental health literacy, and more supportive and responsive school policies can foster dialogue for parental recognition in Colorado and throughout the country.

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The present study examined the relationships between COVID-related stress, mental health and professional burnout in the infant and early child mental health (IECMH) workforce and examined reflective supervision and consultation (RSC) as a potential protective factor in the context of COVID-related stress. Participants included 123 adults (n = 121 female, modal age range 30-39 years) in the TN IECMH workforce (mean years of experience = 13.6 years) surveyed in June/July 2020. Sector representation was quite varied (home visiting, childcare, child welfare, early intervention). Results indicated the majority (63%) of the sample was caring for someone else (e.g., child or elderly person) while working at home, 46% of the sample had depression symptoms (18% in the moderate-severe range), and 75% of the sample had anxiety symptoms (33% in the moderate-severe range). Higher COVID stress was associated with higher internalizing symptoms and burnout levels and this relationship was mediated by self-care behaviors such that the more COVID stress one reported, the fewer self-care behaviors they engaged in, and the higher the risk for internalizing and burnout. Finally, the pathway from COVID stress to self-care behaviors was moderated by RSC. IECMH professionals who received less than 1 year (or no experience) of RSC showed a significant decrease in self-care behaviors during times of low, average and high levels of COVID stress compared to those who received 1 year or more of RSC. Implications for both policy and practice will be discussed.